Staging Prostate Cancer
 

There are two times that your gland is "staged". The "clinical" is the stage that the doctor assigns when he does a DRE (Digital Rectal Examination) or a "finger wave" as some might call it. The second is the "pathological" stage which would be done following the biopsy and also following surgery to remove the gland.

Many of the studies and charts are based on the "clinical" stage but some are based on the "pathlogic" stage - one must read carefully to understand which one is being talked about or used.


The pathologic stage will many times be higher than the clinical stage simply because in the biopsy the doctor is able to see something that the DRE (Digital Rectal Examination) could ot find. It would be the most accurate (other than one following surgery) but may not always reflect to a particular study.


Here is a listing of the stages and what the N0 and Mx would mean




Primary Tumor (T)


T0      No evidence of primary tumor


T1      Clinically inapparent tumor not palpable or

        visible by imaging


       T1a     Tumor incidental histologic finding in

                5% or less of tissue resected


        T1b     Tumor incidental histologic finding in

                more than 5% of tissue resected


        T1c     Tumor identified by needle biopsy (e.g.

                because of elevated PSA)


T2      Palpable tumor confined within prostate


        T2a     Tumor involves 50% or less of one lobe


        T2b     Tumor involves 50% or more on one lobe


        T2c     Tumor involves both lobes


T3      Tumor extends through the prostatic capsule


        T3a     Extracapsular extension (unilateral)


        T3b     Extracapsular Extension (bilateral)


        T3c     Tumor invades seminal vesicle(s)


T4      T4a     Tumor is fixed or invades adjacent

                structures including bladder neck,

                and/or external sphincter, or rectum.


        T4b     Invaded other areas near the prostate.


Primary Tumor, Pathologic (pT)


pT2     Organ confined


        pT2a    Unilateral


        pT2b    Bilateral


pT3     Extraprostatic extension


        pT3a    Extraprostatic extension


        pT3b    Seminal vesicle invasion


pT4     Invasion of bladder, rectum


Regional Lymph Nodes (N)


NX      Regional lymph nodes cannot be assessed


N0      No regional lymph node metastasis


N1      Metastasis in regional lymph node or nodes

        (2cm or smaller at greatest dimension)


N2      Metastasis in regional lymph node or nodes

        (between 2cm and 5 cm at greatest dimension)


N3      Metastasis in regional lymph node or nodes

          (more than 5cm at greatest dimension)


Distant Metastasis (M)


MX      Distant metastasis cannot be assessed


M0      No distant Metastasis


M1      Distant metastasis


        M1a     Nonregional lymph nodes


        M1b     Bone(s)


        M1      Other site(s)


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